The standard surgical technique for repair of perineal hernia uses a prosthetic mesh,[3] but this technique has a high rate of failure due to insufficient anchoring. Promising techniques to reduce the rate of failure include an orthopedic anchoring system,[4] a gluteus maximus muscle flap,[1][5] an acellular human dermis graft,[5] and an acellular pig collagen graft.[6]

Dogs with benign prostatic hyperplasia have been found to have increased relaxin levels and suspected subsequent weakening of the pelvic diaphragm.[10] In cats, perineal hernias are seen most commonly following perineal urethrostomy surgery or secondary to megacolon.[11] Medical treatment consists of treatment of the underlying disease, enemas, and stool softeners. Because only about 20 percent of cases treated medically are free of symptoms, surgery is often necessary.[11] Recurrence is common with or without surgery.

Several surgeries have been described for perineal hernias in dogs. The current standard involves transposition of the internal obturator muscle. This technique has a lower recurrence and complication rate than traditional hernia repair. A new technique uses porcinesmall intestinalsubmucosa as a biomaterial to help repair the defect. This is can also be done in combination with internal obturator muscle transposition, especially when that muscle is weak.[12]